Risk factors for aspiration pneumonia in geriatric patients with dementia and prolonged dysphagia

Youssef, Gamal; Elsherbiny, Mona S; Abdelhamid, Ahmed

doi:10.21608/ejnso.2021.149892

Risk factors for aspiration pneumonia in geriatric patients with dementia and prolonged dysphagia

Document Type : Original Article

Authors

¹ 1. Phoniatrics Unit, ENT Dep. Faculty of medicine/Alexandria University/Alexandria/Egypt. 2. ENT Dep. Dubai Hospital /Dubai health authority (DHA)/, Dubai/UAE

² Department of Geriatric Medicine, Elderly care unit, DHA, Dubai, UAE.

³ Phoniatrics unit, ENT department, Ain shams University, Cairo, Egypt.

10.21608/ejnso.2021.149892

Abstract

Background: Dysphagia is an obvious risk factor for aspiration pneumonia in old age patients, especially those who are having dementia. The study aimed to determine the risk factors responsible for the development of aspiration pneumonia in geriatric patients with dementia and dysphagia in order to enable the development of a particular preventive program accordingly.
Patients and Methods: The study recruited 98 patients diagnosed with dementia and dysphagia classified into patient and control groups according to the presence of aspiration pneumonia. Data collected included demographic and medical assessment data. Dementia severity was assessed with the clinical dementia rating (CDR) scale. According to the results of bedside clinical swallowing assessment and the Fiberoptic endoscopic evaluation of swallowing (FEES) results, the severity of swallowing impairment was determined by using the functional oral intake scale (FOIS), oropharyngeal secretion collection, penetration aspiration scale (PAS), and pharyngeal stasis scale.
Results: Patients with aspiration pneumonia were of longer hospital stay duration, with more percentage of malnutrition, recent stroke, and comorbidities with RR (risk ratio) of 3.22, 1.59 and 3.8 respectively. FEES outcome revealed significant differences between the two groups in all measures of dysphagia severity. The risk factors of aspiration pneumonia were severe penetration aspiration, combined tube, and oral feeding, malnutrition, comorbidities, and severe dementia.
Conclusion: The predictive risk factors for the development of aspiration pneumonia in dementia patients with dysphagia were malnutrition, comorbidities, severe dementia, and severe aspiration scale and tube feeding. These findings should be integrated into clinical practice to prevent aspiration pneumonia.

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